Software Bottom Line

Streamlining expenses and refining services dominate current technology trends.

For the past few years, senior living software has been steadily increasing in functionality and spreading into all areas of operations.But economic conditions have forced a shift in focus from software bells and whistles to the much-needed basics-how operators can use software platforms to perform specific functions and streamline expenses while maintaining the highest levels of quality care to residents.

And while there is still value in software integration-using one all-encompassing operational system that addresses a range of tasks-leading software suppliers are heeding provider feedback and offering solutions that tackle individual challenges.

Niche Needs

Software suppliers that are leaders in specific niches and those that have separate modules within their comprehensive packages have an advantage right now, says Tom Patten, president and CEO of PALs Software, based in Duluth, Minnesota.

Most of the calls Patten fields now are from current and prospective customers who need help with basic regulatory or service delivery challenges. Examples include maintaining error-free medication management services, providing compliance alerts for nurses, or documenting services more efficiently. Smart operators know that "profitability and regulatory compliance go hand in hand," Patten adds.

Of course, this trend doesn't mean providers are no longer interested in purchasing comprehensive software packages; however, those investments are more likely to occur in a better economy. As a result, the more efficiently a supplier serves providers now may influence future business, when those companies are ready to upgrade, Patten says. Providers should look to software companies with product packages that require less upfront investment, such as monthly subscription charges versus buying the software package outright. Internet hosting prices have also gone down, which can contribute to software-related cost savings.

Overall, providers have been steadily refining their current software needs, says Robert Mann, co-owner of Wichita, Kansas-based INTRAcare. This is working to streamline expenses and maintain quality care services; however, many providers know a down economy is not the time to slash marketing. It's important to invest in marketing, particularly in tight economic times when some competitors may not be as visible in the market. Lately, Mann says, sales and marketing modules have been the most popular among operators.

"They come to us with high hopes of putting in a fully integrated operational management package, but their biggest needs are solutions to help them fill their buildings," Mann says. "We can offer that individually and then they can step up later" with other functions. Software suppliers must be flexible, he adds, especially now. And providers should demand that kind of service.

Essential Benchmarking Tools

Much has been made of how software can help providers identify their lowest performing communities for improvement. In this rough economy, though, such benchmarking functions also help identify an ailing property or group of properties. Equipped with comprehensive data, a company could decide to sell those properties instead of investing in a strategy that would prevent foreclosure or receivership, Mann says. In those situations, software portability becomes an additional plus. A company can ask the software supplier if that residence can be packaged into a freestanding customer account so its operational data can be easily transferred in a sale.

Other areas software can help tackle, particularly in tight economic times, include distinguishing your company among its closest market competitors and increasing resident retention and move-ins, says Elizabeth Wheatley, corporate director of clinical services for Newton, Massachusetts-based Five Star Senior Living, which relies on A.L. Wizard software to support operations at more than 200 communities.

Wheatley says meeting these goals starts with the time employees save by using the software to efficiently conduct, track, and analyze resident assessments. The data collected and entered for each resident generates a customized service plan which ensures not only that the resident receives the care he or she needs, but also helps manage staff so that care is provided efficiently. The program also tracks and trends resident improvements and declines in various areas, providing valuable data that can be shared with residents and families.

"We've gotten a lot of positive feedback from nurses who are resident service managers," Wheatley says. "They say it's made their life easier and they like the ability to customize service plans. The executive directors are also happy. It generates automatic reports and they know what their staffing needs will be."

While clinical care software has been able to perform these functions for some time, lately more providers are seeing them as a way to weather the downturn, says Jim Wills, CEO and president of A.L. Wizard, based in San Diego. The software developer began targeting the resident assessment space about a decade ago, while many others have since built out their packages from marketing or accounting niches.

Pivotal Partnerships

Another major trend is not in software capabilities or turnkey solutions, but rather in how suppliers interface with providers. "There's no more developing programs and handing them off to customers; there has to be a partnership," says Rita Burgett, president of Move-N Software, based in Bedford, Texas.

Especially in tough times, it's critical that the software supplier is going to be there to ensure providers' needs are really met, she adds. Important questions to ask prior to investing in any kind of software package include:

• What is the software company's process for product development?

• Does it use focus groups and talk to customers about their needs and how to make software user-friendly?

• What is the process the company uses to make product changes and upgrades?

• How long has the company retained the same programmers?

• Is tech support handled in house?

The leading senior living software suppliers all bring their customers on board as they hone their products. For example, Move-N sends screen-shot tests to caregivers and asks for feedback. Burgett says this allows the company to make strategic changes. "We develop as the market changes," she explains. "Our only plan for development is when a customer tells us they need something."

INTRAcare also uses customer feedback as a main source during its product development stage, a strategy that has benefited Wichita, Kansas-based Legend Senior Living. Based on the provider's input, INTRAcare was able to provide an operations management software solution that could interface with the provider's payroll/accounts payable program, says Matthew Thornton, vice president of operations.

Five Star Senior Living considered developing a homegrown solution for its resident care needs, but opted for A.L. Wizard because it was more cost-effective and its products were built using provider input, Wheatley says. She also liked that Five Star was able to run pilot tests before making a purchase.

New Devices, Capabilities

PDAs, iPhones, and other handhelds have become an integral part of corporate and mainstream culture. The most exciting development for Burgett is that she can access not just the Internet but the contents of her entire computer, including all files and applications, through technology from her cell phone provider. Indeed, recently she recalls checking her accounting program on her cell phone at the beach.

"Whereas before we had to develop programs and include the technology that goes with them, now we're finding that we have to be compatible with the technology that is out there," Burgett says. "It totally changes the way that we have to do our strategic planning for the future."

Handhelds can make service delivery more efficient, not just for executives and managers to check data in real time wherever they are, but also for caregivers who could pull up service plan task lists and check off each task as it is completed right in a resident's room, Burgett suggests. She predicts that advanced applications, including mobile technology, might even become a must for attracting top young talent. Plus, families already are demanding online access to up-to-date information on loved ones, although HIPAA restrictions and security concerns may slow some of those capacities.

"It's something that's coming; it has to," she predicts.

It may be coming, but it may not be quickly, some software suppliers say. One reason is a question of whether staff, who may even be learning English as a second language, will be intimidated by handheld devices, Wills says. Another question is whether handhelds make the care experience more clinical, and that debate extends to marketing, says Mann.

INTRAcare offers tools to integrate with Microsoft Outlook, making it easy for sales staff to access lead-based info on PDAs. Still, Mann wonders, will too much dependence on handheld devices in the presence of seniors and their families impersonalize the sales process? And overall, he asks, is this technology practical with respect to how senior living operates?

"I think when an operator has mastered the basics of tracking all leads and follow up, performing move-ins real time, doing assessments on regular intervals, and capturing all potential revenue, then these types of tools can make a difference in further streamlining their operations," Mann says.

However, this year, economic strains and uncertainty again clearly are at the top of the list for providers. Purchasing handheld devices for multiple staff is expensive, and because of their size and portability, they are easily damaged or lost, Thornton says.

Kiosk Care

A more likely alternative for onsite service- delivery documentation is kiosk-like terminals outside rooms where caregivers can document delivered services in almost real time, Thornton prognosticates. These would be more affordable and also better meet legal standards for documentation, he says.

Ultimately, what Thornton finds most exciting is not handheld technology but the possibility of integrated-and portable- document imaging and data storage. "If we can input accounts payable documents and save images, that would be an enormous savings for a company this size," he says.

Medication records that have one point of entry that flows seamlessly from the doctor's prescription to the pharmacy to the caregiver who administers the dose is Wheatley's "next dream."

That goal may not be so far away if the current administration continues to spearhead a national electronic medical records system, Wills says. "There's no reason why we, at an assisted living care management level, can't integrate better with products that have health records capabilities," he says. "We just need to build a platform that will make it easier to integrate with products like that."

Whatever is around the corner, even if providers are not spending much now, software companies should not sit idle if they want to remain on the leading edge, says Wills, who says his company plans to make a major announcement soon regarding its newest software modifications. The economy will inevitably return to health, he adds, and providers will again want the latest and greatest.